2016
Desmoteplase 3 to 9 Hours After Major Artery Occlusion Stroke
von Kummer R, Mori E, Truelsen T, Jensen J, Grønning B, Fiebach J, Lovblad K, Pedraza S, Romero J, Chabriat H, Chang K, Dávalos A, Ford G, Grotta J, Kaste M, Schwamm L, Shuaib A, Albers G. Desmoteplase 3 to 9 Hours After Major Artery Occlusion Stroke. Stroke 2016, 47: 2880-2887. PMID: 27803391, DOI: 10.1161/strokeaha.116.013715.Peer-Reviewed Original ResearchConceptsPlacebo-treated patientsSymptomatic intracranial hemorrhageSerious adverse eventsAdverse eventsMRS scoreTreatment armsIntracranial hemorrhagePooled analysisDay 90Major artery occlusionIschemic stroke patientsRankin Scale scoreMajor cerebral arteriesHigh-grade stenosisSignificant clinical benefitExtended time windowIntravenous desmoteplaseArterial recanalizationArtery occlusionIntravenous treatmentIschemic strokePrimary outcomeCerebral arteryRecanalization rateStroke patients
2015
Safety and efficacy of desmoteplase given 3–9 h after ischaemic stroke in patients with occlusion or high-grade stenosis in major cerebral arteries (DIAS-3): a double-blind, randomised, placebo-controlled phase 3 trial
Albers G, von Kummer R, Truelsen T, Jensen J, Ravn G, Grønning B, Chabriat H, Chang K, Davalos A, Ford G, Grotta J, Kaste M, Schwamm L, Shuaib A, Investigators D. Safety and efficacy of desmoteplase given 3–9 h after ischaemic stroke in patients with occlusion or high-grade stenosis in major cerebral arteries (DIAS-3): a double-blind, randomised, placebo-controlled phase 3 trial. The Lancet Neurology 2015, 14: 575-584. PMID: 25937443, DOI: 10.1016/s1474-4422(15)00047-2.Peer-Reviewed Original ResearchConceptsMajor cerebral arteriesHigh-grade stenosisRankin Scale scoreIschemic strokeSymptom onsetCerebral arteryDay 90Scale scorePlacebo-controlled phase 3 trialComputer-generated randomisation listMajor cerebral artery occlusionModified Rankin Scale scoreSymptomatic cerebral edemaSymptomatic intracranial hemorrhageBaseline National InstitutesHealth Stroke ScaleSerious adverse eventsCerebral artery occlusionPhase 3 trialModified Rankin ScaleRandomisation listStroke ScaleStudy drugAdverse eventsArtery occlusion
2008
Intravenous desmoteplase in patients with acute ischaemic stroke selected by MRI perfusion–diffusion weighted imaging or perfusion CT (DIAS-2): a prospective, randomised, double-blind, placebo-controlled study
Hacke W, Furlan A, Al-Rawi Y, Davalos A, Fiebach J, Gruber F, Kaste M, Lipka L, Pedraza S, Ringleb P, Rowley H, Schneider D, Schwamm L, Leal J, Söhngen M, Teal P, Wilhelm-Ogunbiyi K, Wintermark M, Warach S. Intravenous desmoteplase in patients with acute ischaemic stroke selected by MRI perfusion–diffusion weighted imaging or perfusion CT (DIAS-2): a prospective, randomised, double-blind, placebo-controlled study. The Lancet Neurology 2008, 8: 141-150. PMID: 19097942, PMCID: PMC2730486, DOI: 10.1016/s1474-4422(08)70267-9.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBrain IschemiaCerebral HemorrhageDouble-Blind MethodFemaleFibrinolytic AgentsHumansInjections, IntravenousMagnetic Resonance ImagingMaleMiddle AgedPerfusionPlasminogen ActivatorsProspective StudiesSample SizeStrokeTomography, X-Ray ComputedTreatment FailureYoung AdultConceptsSymptomatic intracranial hemorrhageClinical response rateAcute ischemic strokeDiffusion-weighted imagingResponse rateNIHSS scoreIschemic strokeIntracranial hemorrhageLesion volumeDay 90Mortality ratePerfusion imagingScale scoreHealth Stroke Scale scoreMedian baseline NIHSS scoreModified Rankin Scale scoreMagnetic resonance perfusion imagingComposite of improvementBaseline NIHSS scorePlacebo-controlled studyStroke Scale scoreDose-ranging studyRankin Scale scoreSymptoms of strokeOnset of strokeOff-Hour Admission and In-Hospital Stroke Case Fatality in the Get With The Guidelines-Stroke Program
Reeves M, Smith E, Fonarow G, Hernandez A, Pan W, Schwamm L. Off-Hour Admission and In-Hospital Stroke Case Fatality in the Get With The Guidelines-Stroke Program. Stroke 2008, 40: 569-576. PMID: 18988914, DOI: 10.1161/strokeaha.108.519355.Peer-Reviewed Original ResearchConceptsHemorrhagic stroke admissionsOff-hour presentationIschemic stroke admissionsQuality of careHospital case fatalityStroke admissionsHospital mortalityHours presentationCase fatalityIschemic strokeHospital case fatality rateGuidelines-Stroke programGWTG-Stroke programHospital-based outcomesAcute ischemic strokeHospital-level factorsStroke case fatalityTime of presentationCase fatality rateEquation logistic regressionQuality improvement effortsStroke ProgramAcute strokeHemorrhagic strokeHours admissionAdvance Hospital Notification by EMS in Acute Stroke Is Associated with Shorter Door-to-Computed Tomography Time andIncreased Likelihood of Administration of Tissue-Plasminogen Activator
Abdullah A, Smith E, Biddinger P, Kalenderian D, Schwamm L. Advance Hospital Notification by EMS in Acute Stroke Is Associated with Shorter Door-to-Computed Tomography Time andIncreased Likelihood of Administration of Tissue-Plasminogen Activator. Prehospital Emergency Care 2008, 12: 426-431. PMID: 18924004, DOI: 10.1080/10903120802290828.Peer-Reviewed Original ResearchConceptsEmergency medical servicesTissue plasminogen activatorAcute stroke patientsStroke patientsTertiary care stroke centerIntravenous tissue plasminogen activatorCatheter-based thrombolysisED arrival timeHospital time intervalsIntra-arterial thrombolysisMedian National InstitutesHealth Stroke ScaleUse of thrombolysisEmergency department arrivalTerms of ageHigher baseline ratesPrior strokeTPA useAcute strokeStroke centersStroke ScaleSymptom onsetStroke databaseMild strokeHospital notification